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Otology/Neurotology

(466) Surgical Intervention for Hearing Loss Decreases Incident Adverse Life Events

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • Natalie M. Perlov, BS

    Medical student
    Sidney Kimmel Medical College
    Philadelphia, Pennsylvania, United States

    • Co-Author(s)

  • Natalie M. Perlov, BS

    Medical student
    Sidney Kimmel Medical College
    Philadelphia, Pennsylvania, United States

  • Marwin Li, BS

    Medical Student
    Sidney Kimmel Medical College
    Philadelphia , Pennsylvania, United States

  • AK

    Ayan T. Kumar, MD

    Resident Physician
    Thomas Jefferson University
    Philadelphia, Pennsylvania, USA

    • Senior Author(s)

  • ZU

    Zachary D. Urdang, MD, PhD

    Resident
    Monument Health
    Flagstaff, AZ, United States

  • TW

    Thomas O. Willcox, Jr., MD

    Associate Professor, Director Balance & Hearing Center
    Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

  • Rebecca C. Chiffer, MD

    Assistant Professor
    Thomas Jefferson University
    Philadelphia, PA, United States

Disclosure(s):
Natalie M. Perlov, BS: No relevant relationships to disclose.
Marwin Li, BS: No relevant relationships to disclose.
Zachary D. Urdang, MD, PhD: No relevant relationships to disclose.
Thomas O. Willcox, MD, Jr.: No relevant relationships to disclose.


Introduction: Hearing loss (HL) may be undertreated, with reported disparities in care based on race. This database study analyzes the distribution and associations of surgical treatment for HL on the development of adverse life events (ALEs) and systems-based medical comorbidities (MCBs).

Methods: This is a retrospective cohort database study with propensity-score matching (PSM) conducted between July 2022 and January 2023 using the TriNetX Research Network. We included adult patients (≥18 years) with congenital, sensorineural, conductive, and mixed HL (ICD10: H90-91). Surgical intervention following HL included mastoidectomy, cochlear implantation, tympanoplasty, and stapedectomy (CPT: 1010163, 69930, 1010183, 1010191, 1014244).
We hypothesized that surgical otologic intervention for HL (HL+) is associated with decreased odds for incident ALEs and MCBs, and that distribution of these services is associated with race. We calculated odds-ratios with 95% confidence intervals (OR(95%CI)) for new ALEs (Z55-Z65) or MCBs after HL diagnosis.

Results: We identified 2,891,379 control patients. After 1:1 PSM for age and race, HL+ (n = 59,462) had lower odds for new ALEs (0.46(0.43-0.49)) and all MCBs (0.66(0.63-0.69)). Notably, HL+ had lower odds of illiteracy (0.49(0.41-0.58)) and unemployment (0.45(0.39-0.51)). Among systemic MCBs, HL+ had lower odds of cardiovascular disease (0.61(0.49-0.64)) and all cancers (0.55(0.53-0.57)). Covariate analysis of demographics showed more African-American patients in controls vs HL+ (p < 0.0001), and the opposite trend for Caucasian patients (p = 0.0008).

Conclusions: Surgical intervention for adult hearing loss is associated with lower odds for incident ALEs and systemic MCBs. These findings represent the largest cohort study to date demonstrating this association and further support that hearing restoration improves patient socioeconomic and medical outcomes with affiliated societal economic impact. Our findings additionally emphasize the need to enhance equity for hearing screening and early access to surgical hearing restoration.